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©2013 UpToDate ® Print Email Standard prophylaxis for bacterial and fungal infections after lung transplantation* Bacterial • : Ceftazidime: 2 g IV with induction of anesthesia, then 1 g IV every 8 hours for 7 to 10 days.Δ Vancomycin: 1 g IV with induction of anesthesia, then 1 g IV every 12 hours for 7 to 10 days.Δ Fungal: Inhaled nebulized amphotericin B lipid complex (ABLC) 50 mg daily for extubated patients and 100 mg daily for intubated patients. Regimen should continue for four days, then weekly while hospitalized. Nystatin suspension 5 cc swish & swallow four times per day for 6 months post-transplant. Pneumocystis jirovecii (formerly P. carinii): Trimethoprim-sulfamethoxazole 1 double-strength tablet orally three times per week starting within one week postoperatively, continuing indefinitely.Δ◊§ * See appropriate topic reviews for antiviral prophylaxis recommendations. • The standard regimen should be adjusted as indicated to include coverage for any other known preoperative pathogens in the recipient. This is particularly indicated for recipients with cystic fibrosis, bronchiectasis, and other septic lung diseases. Coverage should also be modified to include for any additional organisms identified from donor bronchial washings. Δ Doses should be adjusted for renal insufficiency. ◊ If sulfa allergic: Atovaquone 1500 mg once daily or dapsone 50 mg or 100 mg orally once daily or aerosolized pentamidine 300 mg monthly or 4 mg/kg pentamidine IV monthly, continuing indefinitely. § If toxoplasmosis mismatch (donor positive/recipient negative), trimethoprim-sulfamethoxazole should be dosed at 1 double-strength tablet orally once daily.